Depression and chronic pain in the elderly: links and management challenges

Abstract

Panagiotis Zis,1 Argyro Daskalaki,2 Ilia Bountouni,3 Panagiota Sykioti,3 Giustino Varrassi,4 Antonella Paladini5 1Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; 2Department of Neurology, Evangelismos General Hospital, Athens, Greece; 3Belgrave Liaison Team, Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; 4Fondazione Paolo Procacci and European League against Pain, Rome, 5Department of MESVA, University of L’Aquila, L’Aquila, ItalyAbstract: Aging is an inevitable process and represents the accumulation of bodily alterations over time. Depression and chronic pain are highly prevalent in elderly populations. It is estimated that 13% of the elderly population will suffer simultaneously from the two conditions. Accumulating evidence suggests than neuroinflammation plays a critical role in the pathogenesis of both depression and chronic pain. Apart from the common pathophysiological mechanisms, however, the two entities have several clinical links. Their management is challenging for the pain physician; however, both pharmacologic and nonpharmacologic approaches are available and can be used when the two conditions are comorbid in the elderly patients.Keywords: depression, chronic pain, elderly, neuroinflammation, cognitive impairment, pain

Keywords

• depression
• chronic pain
• elderly
• neuroinflammation